This week, Congress and the White House need to finalize a large spending bill to avoid a government shutdown. At this moment, all signs point to a deal being reached, as the President already signed H.R. 5895 into law, assuring the departments of Veterans Affairs and Energy, the Legislative Branch, and military construction and water projects are funded. The House is expected to take up H.R. 6157 this week which would fund 70 percent of the government, including the Departments of Defense, Labor, HHS, and Education.

H.R. 6157 also includes language to extend funding for all outstanding federal agencies through December 7th. This would presumably include funding for the Departments comprised in bill H.R. 6147, which includes Agriculture, FDA, Interior, EPA, Transportation, and HUD. A fourth package which has been stalled since early in the summer includes Financial Services, Homeland Security, Commerce, State, and Justice Departments. We wait and see if there are any hiccups in clearing the September 30th funding hurdle.

Also on our radar this week: does Congress pass an opioids package? House and Senate staffers spent the weekend hashing out the final details with the expectation of a bill being released early this week perhaps as soon as Monday. How are issues around the IMD exclusion and patient privacy (referred to as 42 CFR) addressed? Additionally, we wait and see whether Medicare Part D changes supported by PhRMA, like a scaling back of the donut hole, make it into the final package.

A final version of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPA) of 2018, H.R. 6378, is likely to be on the House floor on Tuesday. The bill would reauthorize key provisions for the HHS' Assistant Secretary for Preparedness and Response (ASPR) to stockpile medicines, respond to disasters or biologic threats and support new drugs to fight pandemic threats like influenza.

While most of Washington will have its eyes on the Senate Judiciary Committee this week, the House will likely wrap up its legislative work this week prior to the midterms, which includes a number of consequential health priorities. We will stay focused on these consequential health care actions that may occur and what it may mean for the lame duck.

MEDICAID WORK REQUIREMENTS

If Democrats take control of either House in this election, Medicaid work requirements will be in their sights following reports that CMS will review Alabama's stringent request to require able-bodied adult's report 35 hours of work per week in order to maintain coverage. Given Alabama's very limited Medicaid coverage of childless adults, it is hard to understand how anyone can work 35 hours per week and still be eligible. Expect significant scrutiny of the details.

THIS WEEK IN THE HOUSE

On Thursday (9/27), the Energy & Commerce Health Subcommittee will hold a hearing titled, "Better Data and Better Outcomes: Reducing Maternal Mortality in the U.S."

THIS WEEK IN THE SENATE

On Tuesday (9/25), the Senate HELP Committee will hold a hearing titled, "Health Care in Rural America: Examining Experiences and Costs."

On Thursday (9/27), the Senate HELP Committee will hold a hearing titled, "Reducing Health Care Costs: Improving Affordability through Innovation."